{"id":668,"date":"2021-08-27T15:17:27","date_gmt":"2021-08-27T15:17:27","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=668"},"modified":"2021-08-27T15:17:30","modified_gmt":"2021-08-27T15:17:30","slug":"ho-thanh-bung-o-tre-em","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/ho-thanh-bung-o-tre-em\/","title":{"rendered":"H\u1edf th\u00e0nh b\u1ee5ng \u1edf tr\u1ebb em"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>\u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/p>\n\n\n\n<ul><li>H\u1edf th\u00e0nh b\u1ee5ng (h\u00ecnh 1): khi\u1ebfm khuy\u1ebft l\u1edbp c\u01a1 b\u00ean ph\u1ea3i ch\u00e2n cu\u1ed1ng r\u1ed1n l\u00e0m cho c\u00e1c t\u1ea1ng tho\u00e1t ra ngo\u00e0i, th\u01b0\u1eddng l\u00e0 ru\u1ed9t, th\u1ec9nh tho\u1ea3ng c\u00f3 gan, tinh ho\u00e0n ho\u1eb7c bu\u1ed3ng tr\u1ee9ng.<\/li><li>H\u1edf th\u00e0nh b\u1ee5ng th\u01b0\u1eddng \u0111i k\u00e8m ru\u1ed9t xoay b\u1ea5t to\u00e0n, teo ru\u1ed9t (10-15%), t\u00fai th\u1eeba Meckel. Hi\u1ebfm g\u1eb7p d\u1ecb t\u1eadt c\u00f3 li\u00ean quan \u0111\u1ebfn di truy\u1ec1n.<\/li><li>L\u1ed7 khi\u1ebfm khuy\u1ebft th\u01b0\u1eddng nh\u1ecf h\u01a1n 4cm.<\/li><li>H\u1edf th\u00e0nh b\u1ee5ng 1\/10.000-1\/6.000, tr\u1ebb th\u01b0\u1eddng sanh non, g\u1eb7p tr\u00ean nh\u1eefng b\u00e0 m\u1eb9 tr\u1ebb, nh\u1ecf h\u01a1n 20 tu\u1ed5i.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"912\" height=\"296\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-1-1.jpg\" alt=\"\" class=\"wp-image-670\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-1-1.jpg 912w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-1-1-300x97.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-1-1-768x249.jpg 768w\" sizes=\"(max-width: 912px) 100vw, 912px\" \/><figcaption><strong>H\u00ecnh 1: H\u1edf th\u00e0nh b\u1ee5ng<\/strong><br>M\u0169i t\u00ean tr\u1eafng: l\u1ed7 h\u1edf th\u00e0nh b\u1ee5ng v\u00e0 ru\u1ed9t tho\u00e1t v\u1ecb &#8211; m\u0169i t\u00ean \u0111en: d\u00e2y r\u1ed1n<br><em>\u201cNgu\u1ed3n: Nwomeh, 2012\u201d.<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<p><strong><em>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/em><\/strong><\/p>\n\n\n\n<ul><li>D\u00e2y r\u1ed1n b\u00ecnh th\u01b0\u1eddng, l\u1ed7 khi\u1ebfm khuy\u1ebft th\u01b0\u1eddng b\u00ean ph\u1ea3i cu\u1ed1ng r\u1ed1n,<\/li><li>C\u01a1 th\u00e0nh b\u1ee5ng b\u00ecnh th\u01b0\u1eddng, \u1ed5 b\u1ee5ng k\u00e9m ph\u00e1t tri\u1ec3n,<\/li><li>T\u1ea1ng tho\u00e1t v\u1ecb th\u01b0\u1eddng l\u00e0 ru\u1ed9t, \u0111\u00f4i khi l\u00e0 d\u1ea1 d\u00e0y, hi\u1ebfm g\u1eb7p gan, tinh ho\u00e0n, bu\u1ed3ng tr\u1ee9ng.<\/li><\/ul>\n\n\n\n<p><strong><em>C\u1eadn l\u00e2m s\u00e0ng<\/em><\/strong><\/p>\n\n\n\n<ul><li>Huy\u1ebft \u0111\u1ed3.<\/li><li>\u0110\u00f4ng m\u00e1u to\u00e0n b\u1ed9.<\/li><li>\u0110\u01b0\u1eddng huy\u1ebft.<\/li><li>Ch\u1ee9c n\u0103ng gan th\u1eadn, ion \u0111\u1ed3.<\/li><li>X Quang ph\u1ed5i.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<p><strong>Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<ul><li>B\u00f9 \u0111\u1ee7 d\u1ecbch (200 &#8211; 300ml d\u1ecbch\/kg\/24gi\u1edd \u0111\u1ea7u).<\/li><li>Tr\u00e1nh h\u1ea1 th\u00e2n nhi\u1ec7t.<\/li><li>\u0110\u1eb7t th\u00f4ng d\u1ea1 d\u00e0y gi\u1ea3i \u00e1p.<\/li><li>Gi\u1eef \u1ea9m kh\u1ed1i tho\u00e1t v\u1ecb, b\u1ea3o v\u1ec7 tr\u00e1nh ch\u1ea5n th\u01b0\u01a1ng c\u00e1c t\u1ea1ng trong kh\u1ed1i tho\u00e1t v\u1ecb b\u1eb1ng t\u00fai ch\u1ea5t d\u1ebbo v\u00f4 tr\u00f9ng. &nbsp;<\/li><li>Ch\u1ed1ng nhi\u1ec5m tr\u00f9ng b\u1eb1ng kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng.<\/li><li>\u0110\u1ea3m b\u1ea3o ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p, tim m\u1ea1ch, th\u1eadn \u1ed5n \u0111\u1ecbnh.<\/li><li>\u0110\u00e1nh gi\u00e1 c\u00e1c v\u1ea5n \u0111\u1ec1 \u0111i k\u00e8m nh\u01b0 sanh non, suy h\u00f4 h\u1ea5p.<\/li><li>Ph\u1eabu thu\u1eadt n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ngay khi t\u00ecnh tr\u1ea1ng huy\u1ebft \u0111\u1ed9ng h\u1ecdc \u1ed5n \u0111\u1ecbnh.<\/li><\/ul>\n\n\n\n<p><strong>Ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt<\/strong><\/p>\n\n\n\n<p><strong><em>Ph\u1ee5c h\u1ed3i th\u00e0nh b\u1ee5ng m\u1ed9t th\u00ec: <\/em><\/strong>khi \u00e1p l\u1ef1c \u1ed5 b\u1ee5ng &lt; 20mmHg.<\/p>\n\n\n\n<ul><li>K\u00e9o d\u00e3n th\u00e0nh b\u1ee5ng.<\/li><li>L\u00e0m s\u1ea1ch ph\u00e2n su trong \u0111\u1ea1i tr\u00e0ng.<\/li><li>Gi\u1ea3i \u00e1p d\u1ea1 d\u00e0y v\u00e0 ru\u1ed9t.<\/li><li>Th\u00e1m s\u00e1t to\u00e0n b\u1ed9 \u1ed5 b\u1ee5ng, ki\u1ec3m tra k\u0129 c\u00e1c d\u1ecb t\u1eadt c\u1ee7a ru\u1ed9t tr\u01b0\u1edbc khi \u0111\u01b0a v\u00e0o \u1ed5 b\u1ee5ng, n\u1ebfu c\u00f3 teo ru\u1ed9t m\u00e0 \u0111o\u1ea1n ru\u1ed9t c\u00f2n t\u1ed1t c\u00f3 th\u1ec3 c\u1eaft n\u1ed1i ru\u1ed9t, n\u1ebfu ru\u1ed9t vi\u00eam nhi\u1ec5m, ph\u00f9 n\u1ec1 nhi\u1ec1u, c\u00f3 th\u1ec3 \u0111\u01b0a v\u00e0o \u1ed5 b\u1ee5ng v\u00e0 m\u1ed5 th\u00ec 2 v\u00e0i tu\u1ea7n sau \u0111\u00f3.<\/li><\/ul>\n\n\n\n<p><strong><em>Ph\u1ee5c h\u1ed3i th\u00e0nh b\u1ee5ng hai th\u00ec<\/em><\/strong>: t\u0103ng \u00e1p l\u1ef1c \u1ed5 b\u1ee5ng &gt; 20mmHg g\u00e2y c\u1ea3n tr\u1edf h\u00f4 h\u1ea5p, c\u1ea3n tr\u1edf h\u1ed3i l\u01b0u c\u00e1c t\u0129nh m\u1ea1ch chi d\u01b0\u1edbi, th\u1eadn, ru\u1ed9t.<\/p>\n\n\n\n<ul><li>S\u1eed d\u1ee5ng k\u0129 thu\u1eadt Silo v\u1edbi t\u00fai ch\u1ea5t d\u1ebbo (h\u00ecnh 2).<\/li><li>T\u1ea1ng s\u1ebd \u0111\u01b0a d\u1ea7n v\u00e0o \u1ed5 b\u1ee5ng trong 1 &#8211; 2 tu\u1ea7n (h\u00ecnh 3A).<\/li><li>Ph\u1ee5c h\u1ed3i th\u00e0nh b\u1ee5ng (h\u00ecnh 3B).<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-full\"><img loading=\"lazy\" width=\"320\" height=\"180\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-2.jpg\" alt=\"\" class=\"wp-image-671\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-2.jpg 320w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-2-300x169.jpg 300w\" sizes=\"(max-width: 320px) 100vw, 320px\" \/><figcaption><strong>H\u00ecnh 2. \u0110\u1eb7t t\u00fai silo \u0111\u01b0a d\u1ea7n t\u1ea1ng tho\u00e1t v\u1ecb v\u00e0o \u1ed5 b\u1ee5ng<\/strong><br>(<a href=\"https:\/\/www.chop.edu\/conditions-diseases\/gastroschisis\">https:\/\/www.chop.edu\/conditions-diseases\/gastroschisis<\/a>)<\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"754\" height=\"437\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-3.jpg\" alt=\"\" class=\"wp-image-672\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-3.jpg 754w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/ho-thanh-bung-3-300x174.jpg 300w\" sizes=\"(max-width: 754px) 100vw, 754px\" \/><figcaption><strong>H\u00ecnh 3: A. T\u1ea1ng tho\u00e1t v\u1ecb v\u00e0o \u1ed5 b\u1ee5ng sau \u0111\u1eb7t t\u00fai silo. B. Th\u00e0nh b\u1ee5ng sau khi \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i.<\/strong><br><em>\u201cNgu\u1ed3n: Islam, 2019\u201d.<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<p><strong>Sau m\u1ed5<\/strong><\/p>\n\n\n\n<ul><li>Theo d\u00f5i \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch trung \u01b0\u01a1ng, \u00e1p l\u1ef1c \u0111\u01b0\u1eddng th\u1edf.<\/li><li>Nu\u00f4i \u0103n t\u0129nh m\u1ea1ch ho\u00e0n to\u00e0n.<\/li><li>Ti\u1ebfp t\u1ee5c \u0111i\u1ec1u ch\u1ec9nh c\u00e1c r\u1ed1i lo\u1ea1n tr\u01b0\u1edbc m\u1ed5: n\u01b0\u1edbc, \u0111i\u1ec7n gi\u1ea3i, th\u0103ng b\u1eb1ng ki\u1ec1m toan, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/li><li>Gi\u1eef th\u00f4ng d\u1ea1 d\u00e0y h\u00fat li\u00ean t\u1ee5c cho \u0111\u1ebfn khi ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng ru\u1ed9t. N\u1ebfu sau 3 tu\u1ea7n ch\u1ee9c n\u0103ng ru\u1ed9t ch\u01b0a ph\u1ee5c h\u1ed3i, ch\u1ee5p X-quang c\u1ea3n quang ki\u1ec3m tra.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Bi\u1ebfn ch\u1ee9ng &#8211; theo d\u00f5i<\/strong><\/p>\n\n\n\n<p><strong>Bi\u1ebfn ch\u1ee9ng s\u1edbm<\/strong><\/p>\n\n\n\n<ul><li>T\u0103ng \u00e1p l\u1ef1c \u1ed5 b\u1ee5ng: b\u1ee5ng c\u0103ng ch\u01b0\u1edbng, n\u01b0\u1edbc ti\u1ec3u gi\u1ea3m, toan m\u00e1u k\u00e9o d\u00e0i.<\/li><li>Bung v\u1ebft m\u1ed5.<\/li><li>Ho\u1ea1i t\u1eed ru\u1ed9t, t\u1eafc ru\u1ed9t.<\/li><li>R\u00f2 ti\u00eau h\u00f3a.<\/li><li>Suy th\u1eadn, t\u1ed5n th\u01b0\u01a1ng gan.<\/li><li>Suy h\u00f4 h\u1ea5p.<\/li><li>Nhi\u1ec5m tr\u00f9ng huy\u1ebft, nhi\u1ec5m tr\u00f9ng v\u1ebft m\u1ed5.<\/li><\/ul>\n\n\n\n<p><strong>Bi\u1ebfn ch\u1ee9ng mu\u1ed9n:<\/strong>&nbsp;do t\u0103ng \u00e1p l\u1ef1c \u1ed5 b\u1ee5ng khi \u0111\u00f3ng b\u1ee5ng th\u00ec 1 ho\u1eb7c th\u00ec 2.<\/p>\n\n\n\n<ul><li>Tho\u00e1t v\u1ecb th\u00e0nh b\u1ee5ng.<\/li><li>Tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n.<\/li><li>Vi\u00eam th\u1ef1c qu\u1ea3n.<\/li><li>T\u1eafc ru\u1ed9t do d\u00ednh.<\/li><li>Tho\u00e1t v\u1ecb b\u1eb9n.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1i kh\u00e1m<\/strong><\/p>\n\n\n\n<ul><li>T\u00e1i kh\u00e1m 1 tu\u1ea7n, 1 th\u00e1ng, 3 th\u00e1ng, 6 th\u00e1ng, 1 n\u0103m.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ti\u00ean l\u01b0\u1ee3ng<\/strong><\/p>\n\n\n\n<ul><li>S\u1ed1ng c\u00f2n v\u00e0o kho\u1ea3ng 80-90% c\u00e1c tr\u01b0\u1eddng h\u1ee3p.<\/li><\/ul>\n\n\n\n<p><strong><em>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/em><\/strong><\/p>\n\n\n\n<ul><li><a href=\"https:\/\/www.chop.edu\/conditions-diseases\/gastroschisis\">https:\/\/www.chop.edu\/conditions-diseases\/gastroschisis<\/a><\/li><li>Nwomeh B.C. (2012). \u201cAbdominal wall defects\u201d. Surgical care of major newborn malformations. pp 213 \u2013 237.<\/li><li>Islam S. (2019), Congenital Abdominal Wall Defects: Gastroschisis and Omphalocele, Holcomb and Ashcraft\u2019s Pediatric Surgery , 7th ed, Elsevier, pp. 763-779.<\/li><li>Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb B\u1ec7nh vi\u1ec7n Nhi \u0110\u1ed3ng 2.<\/li><\/ul>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u0110\u1ea1i c\u01b0\u01a1ng H\u1edf th\u00e0nh b\u1ee5ng (h\u00ecnh 1): khi\u1ebfm khuy\u1ebft l\u1edbp c\u01a1 b\u00ean ph\u1ea3i ch\u00e2n cu\u1ed1ng r\u1ed1n l\u00e0m cho c\u00e1c t\u1ea1ng tho\u00e1t ra ngo\u00e0i, th\u01b0\u1eddng l\u00e0 ru\u1ed9t, th\u1ec9nh tho\u1ea3ng c\u00f3 gan, tinh ho\u00e0n ho\u1eb7c bu\u1ed3ng tr\u1ee9ng. <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/ho-thanh-bung-o-tre-em\/\" title=\"H\u1edf th\u00e0nh b\u1ee5ng \u1edf tr\u1ebb em\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":669,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,18],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/668"}],"collection":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/comments?post=668"}],"version-history":[{"count":7,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/668\/revisions"}],"predecessor-version":[{"id":679,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/668\/revisions\/679"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/669"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=668"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=668"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=668"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}